Combined Robotic Colon and Liver Resection for Synchronous Colorectal Liver Metastasis: A Movement Toward a New Gold Standard

摘要

Liver metastasis from colorectal cancer is the most common metastatic tumor in the liver. Up to one-third of the patients with colon cancer have metastatic disease on initial presentation and 20 per cent of them have synchronous liver-only metastasis.1 The 5- and 10-year survival benefits of resecting liver metastasis from colorectal cancer has been well established. Most liver and colorectal resections are presently undertaken using the conventional "open" approach and synchronous occurrence often requires two separate operations.3 Recovery from two major operations often delays the administration of adjuvant chemotherapy, which in turn negatively affects the overall survival. A potential solution to this problem is combining both operations, using a minimally invasive approach for colectomy and synchronous metastatic liver lesion(s).4 Our hypothesis in undertaking this study was that minimal invasive combining colon and liver resections can be performed safely with minimal postoperative morbidity and excellent clinical outcomes. We, therefore, designed a prospective registry study to document our initial experience using this approach in our comprehensive digestive health program.